Spinal cord injury

The higher the injury to the spinal cord, the more function is lost.

What is a Spinal Cord Injury?
It is damage to any part of the spinal cord or nerves at the end of the spinal canal.

The "Message Highway": Think of the spinal cord as the highway sending messages between your brain and body. An injury creates a roadblock.

• Complete Injury: All feeling and motor control are lost below the injury.
• Incomplete Injury: Some motor or sensory function remains below the injury.

🚑 EMERGENCY: ACCIDENT PROTOCOL
If you suspect someone has a back or neck injury:

1. DO NOT MOVE THEM. Moving them can cause permanent paralysis.
2. Call 911 immediately.
3. Keep the person still. Place heavy towels on both sides of the neck to prevent movement until help arrives.

Symptoms by Level

The severity of symptoms depends on the "neurological level" of the injury.

1. Tetraplegia (Quadriplegia)

Injury Level: Cervical Spine (Neck).
Effect: Arms, hands, trunk, legs, and pelvic organs are all affected. May require breathing assistance.

2. Paraplegia

Injury Level: Thoracic, Lumbar, or Sacral (Back).
Effect: Paralysis affects all or part of the trunk, legs, and pelvic organs. Arms and hands usually function normally.

Anatomy

[Image of spinal cord anatomy and dermatomes]

The spinal cord is protected by bones called vertebrae. Nerves exit the cord to control specific body parts:

• Cervical (Neck): Diaphragm, arms, and hands.
• Thoracic (Upper Back): Chest and abdominal muscles.
• Lumbar (Lower Back): Legs and hips.
• Sacral (Tailbone): Bowel, bladder, and sexual function.

Critical Complications

SCI affects more than just walking; it changes how the body functions internally.

⚠️ AUTONOMIC DYSREFLEXIA
For injuries above T6, a minor irritation (like a full bladder or tight clothes) can trigger a life-threatening spike in blood pressure.
Symptoms: Pounding headache, flushed face, sweating above injury level, slow heart rate.
Action: Sit up immediately, loosen clothes, check bladder/catheter, and seek help.

Other Complications

• Pressure Sores: Because you cannot feel pain, sitting in one spot too long cuts off blood flow, causing skin to die.
• Neurogenic Bladder: The brain cannot control the bladder sphincter, increasing the risk of UTIs and kidney stones.
• Spasticity: Uncontrolled tightening or twitching of muscles.

Diagnosis & Treatment

Diagnosis: CT scans and MRIs determine if the cord is compressed by bone fragments or blood clots.

Acute Treatment

• Immobilization: Traction or braces to align the spine.
• Surgery: To remove bone fragments or stabilize fractured vertebrae.
• Methylprednisolone: A steroid sometimes used within 8 hours of injury to reduce inflammation (though this is debated).

Rehabilitation

Recovery focuses on maximizing independence:

• Physical Therapy: Strengthening existing muscles.
• Occupational Therapy: Learning to dress, eat, and use adaptive devices.
• Robotic Gait Training: Emerging tech to retrain walking patterns.

Lifestyle: Living with SCI

• Skin Checks: You must check your skin (using a mirror) twice a day for red spots to prevent pressure sores.
• Weight Shifts: If in a wheelchair, perform "pressure relief" weight shifts every 15-30 minutes.
• Catheter Care: Strict hygiene is required to prevent urinary tract infections (UTIs).
• Mental Health: Depression is common after injury. Connecting with support groups is a vital part of recovery.

Disclaimer: The content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician regarding any medical condition.